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47 Cards in this Set
- Front
- Back
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Why are dialysis pts anemic?
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Decreased epo production
Decreased RBC survival rate Restricted diet Blood loss on HD |
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What route and how often is Epogen usually given?
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IV or SQ
3x/wk |
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What are the benefits of taking Epogen?
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Increased Hgb
An increased sense of well being More energy Increased appe***e decreased left ventricular hypertrophy Decreased risk of hospitalization |
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What are the adverse effects of Epogen?
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Hypertension
Decreased HD efficiency Clotting of access N/v diarrhea |
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What is the main reason a person would not respond to Epogen?
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Iron deficiency
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What are some reasons a person would not respond to Epogen?
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Iron deficiency
Infection/inflammation (iron makes infection worse) B12 deficiency Elevated PTH Multiple myeloma Blood loss Secondary hyperparathyroidism |
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What do we give for iron deficiency?
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Veneer
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Any time you open something in dialysis...
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...DATE AND INITIAL IT!!!
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What aree some special considerations for Epogen?
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It is stored in the refrigerator and ian inventory count is taken b/c it is so expensive
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What must pt's have for Epogen to be effective?
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Veneer....rapid production of RBC's causes iron store depletion
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What should the transferrin sat value be?
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>20
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What is the primary side effect of Venefer
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Hypotension
For this reason, give Venefer in the first part of tx so we know if the hypotension is from the Venefor or too much fluid removal. |
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What do we do if a person has anaphylactic shock from the Venefer?
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Stop the infusion and give them Benedryl
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What are the side fx of oral iron?
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Dark stool and constipation
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How should oral iron be administered?
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After meals and not with antacids
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What should the PTH level be?
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150-300
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How does Zemplar work?
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It suppresses PTH
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What do you NOT give with Zemplar?
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Anything with Ca in it
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Whqt is Hectorol and what does it do?
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It is a synthetic vit D analog so it increases Ca absorbtion which decreases PTH production
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What are 2 Ca based
Phosphorus binders? |
Tums and PhosLo
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What are two non-calcium based phosphate binders?
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Renelva and Renegal
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What are two really cool things about Renelva and Renegel?
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They may be given to pt's with hypercalcemia and they also decrease cholesterol
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How must phosphate.biders be taken?
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AT THE BEGINNING OF EVERY MEAL AND SNACK!!!!
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What is a drug that lowers PTH, Ca, and Ph that is usually taken at home?
What are its side fx? |
sensipar
Myalgia, dizziness, HTN, N/V, diarrhea |
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Which vitamins are water soluable and should be given after HD tx?
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B and C
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What are some examples of renal failure vitamins?
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Nephrocap, Diatx, Nephrovite, B-plex, Renavit
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What two things do you always do before administering an anti-biotic?
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Check pt allergies and ensure blood cultures have already been drawn if it is the first dose
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What is a side effect of amino glycosides like gentamicin?
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Ototoxicity
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What should we know about anti-fungals?
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They will dialyzer off, so give them after Rx
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What is considered high blood pressure?
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140/90
130/80 for DM and ESRD pt's |
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How much NS can you give before you have to talk to the dr?
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500ml
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When is the flu vaccine contraindicated?
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If the pt has an allergy to eggs or a hx of Guillain Barre
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Now often is the pneumonia vaccine given?
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Every 2 years
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What does Benedryl antagonize?
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Heparin, so it may increase dialyzer clotting
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What are signs of digoxin toxicity?
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N/V, vision changes, photophobia, muscle weakness
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What increases a person's risk of digoxitoxicity?
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Low potassium
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What kind of meds will not dialyzer off?
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Protein binding because protein is a lg molecule
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Qhat size of drug will dialyzer off?
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<500 Dalton's molecular weight
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What OTC meds do we want to avoid?
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Alka Seltzer (it is Na)
MOM ASA Enemas/laxatives Herbal remedies |
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How often are med checks done?
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Q month and after hospitalizations and dr appts
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What 2 meds can a tech administer?
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Lidocaine intradermal and heparin
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When does a multi dose vial expire?
Epogen vial? Zemplar vial? |
28 days
21 days 7 days |
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What are the 5 rights"
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Right dose
Right pt Right route Right time Right drug |
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What PPE is needed for med administration?
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Gown, gloves, face shield
Dialyzer might squirt ya! |
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What is the temp range for medication refrigerators?
How many times should the temp be monitored qday? |
2-8 degrees Celciu s
Twice |
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Who administers the medications?
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THE PERSON WHO DREW IT UP!!
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What is the antidote to heparin?
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Protamine sulfate
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